Nursing

Background: School meal programs are not only government initiatives but also community-driven efforts. Aiming to combat food insecurity among school-aged children effectively, these programs are executed in conjunction with food bank initiatives. Various community groups play a crucial role in the success of both food security initiatives. There is a need to improve community engagement to successfully link school meal programs with food banks to build program synergy, combating food insecurity through a two-sided approach. Aim: This study aims to examine (...) community engagement in school meals program by analyzing its purposeful focus on creating jobs and income-generating opportunities for different community groups, i.e., youths, women, and others. Methods: The Bayesian Mindsponge Framework, combining the reasoning strengths of Mindsponge theory and inference advantages of Bayesian analysis, was employed on a dataset of 126 government representatives who manage large-scale school meal programs in 126 different countries. Results: Findings showed that the school meals program’s purposeful focus on creating jobs and income-generating opportunities for women in the community was positively associated with community engagement, thereby supporting the linkage between the programs and food banks. In contrast, providing jobs and income-generating opportunities for youths and other community groups had an ambiguous association with community engagement in school meal programs. Conclusions: Findings underscore the importance of creating jobs and income-generating opportunities for women to improve community engagement in school meal programs. Formulating strategies that empower woman’s entrepreneurship may foster their involvement and engagement in school meal programs, promising to successfully link these programs with food bank initiatives among implementing countries. (shrink)

Are you familiar with this advice? At work, do not talk about politics or religion or money. But who follows this advice and who does not, and if not, why not? In September, October and November 2023, I was sectioned in North Manchester General Hospital, unfortunately. I rarely heard political views expressed there, or what are ordinarily called political views. (For some people, every view is political.) I was repeatedly asked by a fellow patient what I thought of the conflict (...) in Gaza and told that it was my duty as an intellectual to respond: I did not myself describe myself as an intellectual, by the way; it was a description considered beyond reasonable doubt by the patient and also used by the French care coordinator assigned to me towards my departure time. (No longer available for me as a care coordinator for me, it seems. Did they get rid of all foreign nurses from this team? The manager told me that nurses in her team often wrongly refer to one of my psychiatrists as Dr. Kilmach, because it is an unfamiliar name in England. It is like something from a Buchi Emecheta novel. Have they passed GCSE English, by the way???) In the ward I was in, within North Manchester General, there is a large living/dining room with a large television and a number of chairs and some tables. I recall: I was in this room with hardly any others and there was news on the television about the politician Suella Braverman. A black nurse (born in UK probably), whom I did not often see on the ward, entered the room and loudly said, "I HATE THIS WOMAN," or words very like those. There was someone with her, I believe. I am not sure if there were any other patients apart from me in the room. Why did she say that? (This is a psychiatry ward, by the way. Hey, is that Suella Braverman? Is that not a dragon?!) Does the nurse’s loud statement even cohere with nursing ethics? Various possible motivations for it have occurred to me, of which I shall present four. (i) She simply hates Suella Braverman. (ii) She wants to check what my ethnic loyalties are. Will I feel the need to defend Braverman, being a fellow Asian? (iii) She thinks that it is important for people to have "structure" in the workplace, as children are often thought to benefit from structure, and by saying what she did loudly, she was reinforcing a public social norm to be anti-Conservative in Manchester. (Braverman is a Conservative politician, if it is worth distinguishing politicians by party.) In the privacy of the voting booth, or when voting, one can vote as one pleases, but there need to be "unnecessary social norms" (by my standards) to provide structure. (iv) She has found herself in a position in which people loudly express political views contrary to her own and wonders how best to deal with this, looking to observe my reaction. That’s my possible motivations over! Regarding (iii), probably the advice not to talk about politics, religion, and money would not have got going if incompatible with human nature, or in tension with it: if the average worker really does need more social norms, including ones regarding which political views are acceptable in a given workplace. Regarding (iv), I suppose you can try this: go up to the person loudly expressing a political view and timidly say, "I was advised by my family not to talk about religion, politics, and money in the workplace. Do you think the advice mistaken?". (shrink)

This is a bit messy. In September 2023 - was it the 6th? - I was taken into the MRI (Manchester Royal Infirmary) by the police (about seven of them, all white except a token brown person, Muslim-looking; I remember shouting, "Who’s the man here?" and a young blonde woman said, "I'm the man"; did I see her the other day?) and then moved to North Manchester General Hospital. It was mainly white people at MRI: so many; were there any (...) minorities? I thought hospitals were full of minority workers! By the way, who were those two watching me for so long after I had been injected? In North Manchester General, there were white nurses but ALSO so many ethnic minority nurses: Asians, many blacks (Africans), a person of Chinese origin I believe. (One of my patient friends played Tupac: when I get free? I liked it! “That’s exactly what I was thinking.”) Now I am out and I had a French care coordinator (she said she was clever in her class and wanted a copy of my article, so did the black nurse who visited my house before, what was his name now?); then for more than a year there is an English white man as care coordinator, now joined by a junior white nurse, from MMU (a few months into a first year course, from Sheffield). And the nurse who accompanied the psychiatrist in her psychiatric review at my home on Wednesday was a white woman. I am not racist, but I live in a building full of ethnic minority nurses (or it used to be). Another white nurse and I will start wondering about statistics, distributions, and best explanations: it is a legitimate topic of inquiry, is it not? (When previously inquiring elsewhere, Sean Crawford said words to the effect, what are you expecting? - I can’t remember the exact words, is it in the report I got, when I complained about a job in philosophy? You didn’t advertise it publicly, only internally, and we didn’t hear about it, Paula Satne and I, please forgive me Paula, now Thomas H. Smith’s wife, and you even showed Michael Rush how to apply, he emailed me, which a woman in law suggested was ill-advised; she moved in 2018, so did quite a few: all similar level by my assessment, across four departments maybe. You don’t rate them, I think, but they reserve some “brains” for departure timing? "He does ill-advised things"???) I talked to a nurse who lives in my building about 2 months ago and she said that she had to move out and she was looking for a place and we exchanged numbers, because I thought it might be a good idea to have someone live with me. (Social interaction is a box they tick or not, for how well I am doing? I didn't say that to the care coordinator though!) The nurse is an Asian young woman. I asked her if she likes her job at MRI and she made an expression: I interpreted it as "There are problems." (I can relate to that!) My care coordinator keeps asking if I know enough about her; and says she might work nights and disturb me. (Well, it is like living in a little poem here! You’ll spend time outside anyway. You know what I mean, do you, Spanish footballers, or maybe you don't?). (shrink)

I evaluate Professor Nancy Munn’s criticism in her 1994 review of Dame Professor Marilyn Strathern’s 1991 book Partial Connections that Strathern does not refer to “classic sources.” For one end (getting included in collections of important articles on a topic), I suppose that the material would be better presented with reference to classic sources. More specifically, it would be better for Strathern to refer to the rationale presented by E. Evans-Pritchard for focusing on primitive societies: that it is best to (...) start with simple and move towards more complex. Strathern implies a rejection of this rationale, but it seems her work would benefit from being recast in a more traditional academic format. (shrink)

Bruce Fink, in his A Clinical Introduction to Lacanian Psychoanalysis (which I found helpful and pleasantly written), and Slavoj Žižek have concerns about the liberal parent. When the liberal parent’s child asks why an instruction should be followed, the liberal parent does not with authority assert, "BECAUSE I SAID SO." The liberal parent provides the child with an explanation, e.g. “It is good to go to your grandmother’s because family members should spend time together.” Fink’s worry seems to be that (...) the liberal parent is not installing le nom-du-père, whatever that means! But how many parents are actually like this even in liberal Britain or UK or England? In September 2023, I was transported to North Manchester General Hospital with a mental health problem, after writing a lot. The nurses instructed me to take medication. I refused. A few hours later the nurses instructed me to take medication again. I refused. For the first week, I was in a room by myself rather than a shared dormitory. All these refusals happened on day 1 or 2 of being in this hospital. In the evening, a number of nurses came into my small room - about 15, I think. The nurse whom I had previously refused said, "You have to take these tablets or we will forcibly inject you with medication." There was no explanation of what the medication is, what its side-effects are, and what exactly my rights are in this situation - despite that I had, upon admission, claimed to be a figure of considerable intelligence and some biological knowledge, namely Simone de Beauvoir. I was troubled by the crowd in my room and their threat. I said, "Okay then, I shall take the medication," and duly swallowed the tablets and drank the water provided, in a transparent plastic cup. Do you think these nurses go home and parent as Fink and Žižek imagine? If I remember correctly, they were mostly white people. ("I just don't do what the white man proper does - I don't understand this country"???). (shrink)

Background: The feeding modalities used in school meal programs—such as breakfast, lunch, dinner, snacks, and take-home rations—are influenced by various factors, including supply chain constraints and technical challenges in food distribution. The methods of supply sourcing, whether through domestic or foreign food reserves via in-kind donations or purchases, play a critical role in shaping the feeding options provided. Aim: This study aims to examine the association between supply-sourcing strategies, i.e., domestic and foreign in-kind donations and national-international purchases, with the feeding (...) modalities applied in school meal programs. Methods: The Bayesian Mindsponge Framework, combining the reasoning strengths of Mindsponge Theory and inference advantages of Bayesian analysis, was employed on a dataset of government representatives who manage large-scale school meal programs across 126 countries. Results: The findings revealed that sourcing supplies through in-kind donations from neighboring or distant countries showed a highly reliable negative association with the feeding modalities of school meal programs, while those from the national bodies showed an ambiguous relationship. The purchasing methods—whether domestic or foreign—tended to exhibit positive associations with feeding modalities, though these associations were only weakly reliable. Conclusions: The findings reveal substantial rooms to improve the effectiveness of supply purchasing strategies in enhancing school meal program feeding modalities. Further research is needed to examine the impact of sourcing supplies through domestic in-kind donations on feeding outcomes. Additionally, developing strategic plans to optimize the use of in-kind donations from international organizations is strongly recommended to avoid its negative consequences and further enhance program effectiveness. (shrink)

Background: The feeding modalities applied in countries with school meal programs are varied because these are shaped not only by the national commitments to alleviate food insecurity among children but also by resource availability from national and international agencies. In terms of financial resources, the USA plays a consistent role in providing donations, grants, loans, and loan guarantee programs to support global school feeding. The U.S. Department of Agriculture (USDA) oversees these funding sources for international school meal programs. Aim: This (...) study aims to examine the moderating effect of USDA funding on the relationship between supply purchasing methods and feeding modalities among countries implementing school meal programs. Methods: The Bayesian Mindsponge Framework, combining the reasoning strengths of Mindsponge Theory and inference advantages of Bayesian analysis, was employed on a dataset of 126 government representatives who manage large-scale school meal programs in 126 different countries. Results: The findings indicated that USDA funding has the potential to positively moderate the relationship between foreign supply purchases and the feeding modalities of school meal programs. However, the direct association between foreign purchases and feeding modalities was unclear. Conversely, while USDA funding was found to have a negative moderation effect on the relationship between domestic supply purchases and feeding modalities, it is these domestic purchases that show potential for positively influencing the feeding modalities. Conclusions: Findings underscore the importance of supporting the World Bank and World Food Programme’s recommendation to rely more on local resources and capacities for developing long-term and sustainable school meal programs. Further exploration of the impact of foreign supply purchases on feeding modalities is needed. Formulating strategic plans to better leverage USDA funding for enhancing domestic supply purchases is highly recommended. (shrink)

Healthy eating has long been a focus of professionals and researchers, both to evaluate strategies for improvement and to gain a deeper understanding of its dynamics in order to develop effective promotion methods. This study aims to examine the roles of individuals’ information-seeking abilities and e-health literacy in fostering a healthy eating intention among Iranians. Employing Bayesian Mindsponge Framework analytics on a dataset of 9,755 Iranian participants, the study found positive associations between healthy eating information-seeking ability, e-health literacy, and healthy (...) eating intention among Iranian adults. However, the moderating effect of e-health literacy on the relationship between information-seeking ability and healthy eating intention remains ambiguous. We suggest that enhancing individuals' healthy eating information-seeking abilities and e-health literacy, alongside improving the availability, affordability, and accessibility of reliable healthy eating information, is essential for fostering healthy eating intentions. (shrink)

Coastal engagement activities have been explored for their measurable health benefits, including both physical and mental health outcomes. These activities may foster a deeper sense of connection to nature following every visit to the coast, such as watching the sunset, beach walking, spending time on the beach, wildlife spotting, shell collecting, engaging in beach and water sports, mountain biking, and participating in seagoing activities. However, limited research has examined the moderating effect of nature connectedness on the relationship between these activities (...) and health outcomes, both physically and mentally. This study aimed to analyse how the relationships between coastal activities and perceived mental and general health conditions in the previous year are moderated by the level of nature connectedness among adult visitors. By analyzing the dataset of 1,939 Flemish individuals engaged in the Belgian coast, under the Bayesian Mindsponge Framework (BMF), this study found a crucial moderating role of coastal nature connectedness. Findings showed that coastal activities are negatively associated with mental and general health scores, but with the moderating effect of nature connectedness, this negative association may shift. In each level of nature connectedness, coastal activities showed different effects on mental and general health conditions, with higher improvement found in mental health scores. Findings indicate that, beyond the type of coastal activities, nature connectedness is an essential subjective sense that determines therapeutic benefits. This study highlights the complex interplay of environmental factors, subjective perceptions, and biophysical-psychological interactions in shaping individual health outcomes. There is a need for targeted coastal management strategies to facilitate nature-based activities that promote nature-connectedness and, subsequently, coastal healing capabilities. (shrink)

Cancer research has spent a century refining its answers to a question it has not paused to examine: what kind of thing is cancer? The dominant working object — operative in the textbooks, the funding structure, trial design, and regulatory pathway — is a cell whose internal regulatory machinery has failed. The somatic mutation theory has earned its position by working well inside its zone of validity, producing most of what we currently know how to do. It has also been (...) accumulating anomalies it cannot absorb without ad hoc patches. Tissue specificity of identical mutations. Long-term dormancy of mutationally unchanged cells. Spontaneous regression. The non-mutational induction of cancer-like phenotypes through bioelectric perturbation alone. The unintegrated century-old Warburg effect. Cancers with mutational burdens too low to plausibly drive the disease. The recent partial dissolution of Peto’s paradox on better-controlled vertebrate data. The anomalies share a structural feature: each points beyond the cell to the tissue-level conditions in which the cell sits. This paper argues that the partial-seeing frames already at work in the field — tumor microenvironment research, the Seyfried-Warburg metabolic tradition, Soto and Sonnenschein’s Tissue Organization Field Theory, and Levin’s bioelectric and morphogenetic work — are not separate alternatives to the somatic mutation frame. They are different angles on the same unaccounted-for object: the constraint structure by which a tissue maintains itself as a coherent participant in the larger organism. When the constraint structure is intact, even cells with significant genomic damage usually do not produce cancer. When it fails, even genomically intact cells can begin to behave as cancer behaves. A tumor is not a colony of broken cells; it is what tissue does when it has lost the signal that tells it to be tissue. The mutations are the visible trace of a failure that has already happened upstream. The constraint frame yields five testable predictions, presented in descending order of confidence: convergent tissue-level phenotypes from genomically dissimilar cancers; epidemiological dominance of tissue-level risk factors over germline genetic risk; differential success of tissue-level interventions where cell-targeted ones have plateaued; the cancer trial system as a closed loop selecting for its own working object; and the early-onset cancer epidemic as constraint-failure in real time. The paper closes with an analysis of why the assembly of these frames has not happened despite the pieces being visible for years — institutional infrastructure, frame-stickiness, and the genuine difficulty of seeing distributed relational objects with tools designed for isolable substances. The path forward involves funding the partial-seeing frames at the scale of the dominant one, redesigning trials around tissue-level interventions, and letting the field’s working object update without the update becoming a humiliation. The cells are the trace. The disease is upstream. (shrink)

Three decades of Alzheimer’s research have been organized around the conviction that the disease is, fundamentally, a problem with what is in the brain. Plaques, tangles, misfolded proteins, lost neurons. The most recent generation of disease-modifying therapies clears the targeted material with measurable success and produces, at best, marginal cognitive benefit. The field has been describing this gap as a problem of timing, dosage, or target refinement. This paper proposes that the gap is structural: the disease is not located where (...) the field has been looking. Alzheimer’s, on the account developed here, is not primarily a failure of substrate. It is a failure of the dynamic operation that the substrate is meant to support — the operation by which a brain remains a coherent receiver of the structure presented to it. The paper installs this alternative frame, walks through the documented phenomena that current models cannot account for, and shows that each falls into place when the unit of analysis shifts from substrate to dynamics. What the disease destroys is not the receiver’s components. It is the receiver’s capacity to lock on. (shrink)

The coherence metric κ(T,t) has been defined in prior work as the cross-modal synchronization between a substrate signal and the constraint-network expectation it should track. This paper does three things. First, it formalizes κ rigorously as a bounded, time-varying function on [0,1], specifying its operator definition, its domain-specific operationalization, and its measurement substrate. Second, it formalizes two derived quantities not previously specified: the integral ∫κ(T,t)dt over a time window, which we call the coherence reserve, and the derivative dκ/dt, which we (...) call the coherence velocity. Third, it demonstrates that the three quantities held simultaneously—κ(T,t), ∫κ dt, and dκ/dt—constitute a phase space portrait of the system’s dynamic coherence state, and that this portrait, applied without flinching, yields a single unified structural diagnosis across Alzheimer’s disease, cancer, and addiction: all three are accumulated phase state failures. They do not fail in the same tissue or at the same scale. They fail by the same operation. The pathology in each case is the progressive collapse of the coherence trajectory through a predictable sequence of phase states, each of which is measurable, each of which makes falsifiable predictions about clinical behavior, and none of which is located where the dominant treatment paradigm has been looking. (shrink)

Sundowning — the pronounced worsening of cognitive coherence in late afternoon and evening among patients with Alzheimer’s disease and related dementias, with partial recovery overnight — is among the most clinically familiar and theoretically embarrassing phenomena in the field. It is directional in time. Substrate damage is not. The standard frame describes sundowning, manages its symptoms, and does not explain why a disease of accumulating neuronal loss should produce a phenomenon that systematically gets worse across the day and partially better (...) across the night. This paper, the second in a trilogy, takes sundowning as the directly observable signature of a disease whose actual operation is amplitude depletion in the dynamics that constitute a coherent receiver. The companion paper installed the receiver model and the geometry that supports it. This paper shows that sundowning is what one would predict that geometry to produce, that its directionality is structural rather than incidental, that sleep’s role is restoration rather than recovery, and that the slope at which overnight restoration becomes insufficient is the slope of disease progression itself. Sundowning is not a complication of the disease. It is the disease, made temporally visible. (shrink)

Four converging neuroscience and clinical literatures describe addiction from different vantages: environmental modulation of addictive attractors (Alexander et al., 1978, and the conceptual replication literature that followed); prefrontal cortex dysfunction with measurable deficits in self-awareness and response inhibition (Goldstein & Volkow, 2011); the graded transition from goal-directed to habitual to compulsive behavior, with corresponding shift from ventral to dorsal striatal control (Everitt & Robbins, 2016); the longitudinally documented shame spiral in which negative self-conscious emotion predicts slower decreases in substance use (...) over time (Batchelder et al., 2022); and the formal account of addiction as active Bayesian inference under suboptimal priors (Schwartenbeck et al., 2015; Miller, Kiverstein & Rietveld, 2020). Each captures a slice of the phenomenon. None unifies them. This paper proposes a single structural mechanism — captured resonance, the state in which an attractor stabilizes against the substrate maintaining it, with awareness recruited into the attractor rather than functioning correctively against it — that names what the four literatures have been documenting from different angles. The argument is that addiction is not a disease of the brain in the ordinary sense, nor a failure of will, but a specific geometric pathology in which the faculty that ought to lift the system out of misalignment is instead phase-locked into deepening it. The framework predicts the existing empirical findings, makes specific predictions about which interventions will succeed and which will fail, and places addiction within a wider structural account of how instruments fail. (shrink)

Being compassionate and empathic while making rational decisions is expected from healthcare workers across different contexts. But the daily challenges that these workers face, aggravated by the recent COVID-19 crisis, can give rise to compassion and decision fatigue, which affects not only their ability to meet these expectations but has a significant negative impact on their wellbeing. Hence, it is vital to identify factors associated to their exhaustion. Here, we sought to describe levels of compassion and decision fatigue during the (...) pandemic, and to identify factors related to these forms of exhaustion. We collected data using self-reported questionnaires to measure compassion fatigue, decision fatigue, and grit in five intervals from April to November, 2020 (N = 856). Our results showed a negative correlation between grit and compassion and decision fatigue. We also found that under the circumstances studied grit tends to be higher in technicians, nurses, other professionals (psychologists, social workers), and workers at the Emergency Room (ER), and lower in general practitioners. Compassion fatigue tend to be higher for technicians, whereas decision fatigue was lower for specialists, general practitioners, and technicians, and higher for those working at private hospitals. (shrink)

Our general purpose is to show how a philosophically oriented theoretical foundation, drawn from a lifeworld perspective can serve as a coherent direction for caring practices in education. We argue that both caring and learning share the same ontological foundation and point to this intertwining from a philosophical perspective. We proceed by illustrating shared epistemological ground through some novel educational practices in the professional preparation of carers. Beginning in a phenomenologically oriented philosophical foundation, we will first unfold what this means (...) in the practice of caring, and secondly what it means for education and learning to care in humanly sensitive ways. We then share some ways that may be valuable in supporting learning and health that provides a basis for an existential understanding. We argue that existential understanding may offer a way to bridge the categorisations in contemporary health care that flow from problematic dualisms such as mind and body, illness and well-being, theory and practice, caring and learning. Ways of overcoming such dualistic splits and new existential understandings are needed to pave the way for a care that is up to the task of responding to both human possibilities and vulnerabilities, within the complexity of existence. As such, we argue that caring and learning are to be understood as an intertwined phenomenon of pivotal importance in education of both sensible and sensitive carers. Lifeworld led didactics and reflection, which are seen as the core of learning, constitute an important educational strategy here. (shrink)

The COVID-19 pandemic put immense pressure on healthcare systems globally, including those of highly developed countries like the United States and United Kingdom. During the pandemic, professional nursing organizations were the first to call attention to the disproportionate pandemic-related deaths among Filipino nurses. These organizations played a central role in addressing the various crises Filipino nurses faced due to their vulnerabilities as frontliners, ethnic minorities, and migrants in their host countries. Using the Volatile, Uncertain, Complexity, and Ambiguous (VUCA) framework, this (...) monograph assesses the pandemic-response actions and strategies of PNAA and PNAUK, two Filipino nursing associations in the US and UK. The major themes suggest that the two organizations are multifunctional entities with the capacity to act as lobbyists, research organizations, and decision-makers when adapting, strategizing, and coping with VUCA conditions. These findings corroborate previous findings on the potentiality of diasporic nursing organizations in addressing the gaps in government support for migrant workers in the healthcare industry. (shrink)

Artificial intelligence is now widely accessible and already being used by healthcare researchers throughout various stages in the research process, such as assisting with systematic reviews, supporting data collection, facilitating data analysis and drafting manuscripts for publication. The most common AI tools used are forms of generative AI such as ChatGPT, Claude and Gemini. Generative AI is a type of AI that can generate human-like text, audio, videos, code and images based on text-based prompts inputted by a human user. Generative (...) AI is trained on large amounts of data, and the outputs are sophisticated and can be indistinguishable from a response from a skilled human. In this article, we outline several AI applications that can be used in healthcare research, examining their benefits, limitations and outline best practices for maintaining research integrity and ethical standards. (shrink)

Despite the absence of any pharmacological treatments formally approved for borderline personality disorder (BPD), individuals diagnosed with BPD are routinely prescribed psychiatric medications in combinations or sequences that shift over time. This research examines the lived experiences of medication use among people with a BPD diagnosis, particularly in the context of mental health crises. Drawing on qualitative case data from six individuals diagnosed with BPD, we suggest that medication may function not solely, or even primarily as a clinical tool, but (...) rather as a symbolic and relational artefact within psychiatric encounters. Participants described medication as necessary and destabilising, protective and punitive. Medication was often experienced less as a targeted intervention than as a communicative gesture, something done by clinicians to convey care, manage risk, or reassert authority in the face of affective volatility. Side effects were not merely peripheral inconveniences, but direct, embodied experiences that shaped participants’ sense of agency, selfhood, and recovery. We suggest that psychiatric medication in the context of BPD operates through a teleological logic: its usage lies not only in its biochemical properties, but also in the relational and institutional functions it performs. This offers a challenge to prevailing biomedical framings and calls for a more critically attuned approach to psychopharmacology that centres the meanings, contradictions, and ambivalences embedded in service users’ narratives of BPD experience. (shrink)

Here we abstract the LC oscillation circuit of the physical world into a mathematical axiomatic system, aiming to establish a logical language based on "duality, periodicity, and energy conservation." Traditional mathematics is built on "static points," while this system is built on "dynamic waves." In this world, "zero" is not empty, but the perfect balance of electromagnetic energy. You will find it very suitable for describing the following fields: -/- • Macroeconomics: Treating as production inertia and as market capacity; periodic (...) economic crises are a type of "oscillation." -/- • Biological Rhythms: Fluctuations in the concentration of chemicals within cells. -/- • Logic Circuits: Providing a mathematical description for quantum computing based on phase rather than binary bits. -/- Regarding Pi: In this system, \pi is no longer a "ghost" that cannot be physically drawn; it is the settlement bandwidth of the system's rotation logic. The formula $\frac{T}{\pi} = 2\sqrt{LC}$ reveals a strict mapping between the precision of \pi and the time step T: the effective precision of \pi is locked within the system's hardware constants $\sqrt{LC}$. This implies that a circle is not "drawn" but "iterated." If the time step T is too coarse, the logical bits of \pi will collapse, and the macroscopic "circle" will degrade into a microscopic low-order polygon. Here, \pi acts as the "logical inflation rate" that must be paid for energy to complete one full phase conversion between the Magnetic Element (L) and the Electric Element (C). (shrink)

Household-level water safety is dependent on how water is collected, stored, handled and protected from contamination, especially in rural areas that utilize mixed water sources. This quantitative descriptive-correlational study explored water contamination knowledge and prevention practices for 261 household heads selected through stratified random sampling from eight sitios in a rural Philippine barangay and examined the relationship between the two variables. Data were gathered using a researcher-developed questionnaire covering so- cio-demographic and water-use characteristics, knowledge across four prevention domains, and preventive (...) practices measured on a five-point scale. Descriptive statistics and Spear- man’s rho were used for analysis. Overall knowledge was moderate (mean raw score = 15.89, SD = 2.42); proper disposal had the highest mean percentage score (83.30%), whereas water handling had the lowest (75.25%). Preventive practice was high overall (M = 4.35, SD = 0.61), with very high water-storage practice (M = 4.56, SD = 0.48). Knowledge and preven- tive practice were very weakly and non-significantly correlated (rho = 0.047, p = 0.446). The results suggest that good household water-safety habits can be maintained by experience, habit and local context beyond knowledge alone, and water handling is still a key topic for practical health education. (shrink)

Volumul de față, intitulat „Trilogia știință, filosofie și umanism în asistența socială, volumul 1: Știință, multidisciplinaritate și schimbare în teoria, practica și politica asistenței sociale”, reprezintă prima parte a trilogiei „Știință, filosofie și umanism în asistența socială”, o lucrare de o anvergură teoretică remarcabilă, parte a unui amplu proiect strategic de redefinire a fundamentelor și obiectivelor supreme ale acestui domeniu esențial. Cartea deschide o poartă către o nouă paradigmă, propunându-și cu hotărâre să transforme acest domeniu și această profesie — adesea (...) prizonieră a unor clișee perimate — dintr-o practică preponderent "asistențială", dominată de inerția birocratică și observația pasivă, într-un domeniu al rigoarei științifice de înalt nivel și al acțiunii transformatoare. Încă de la primele pagini, textul stabilește un diagnostic sever și curajos al stării actuale a sistemului, disecând critic, cu argumente solide, tendința nocivă de a privi problemele sociale ca realități imuabile, date sau aproape „naturale”, pe care asistentul social este chemat doar să le gestioneze, să le catalogheze sau să le atenueze, în loc să le rezolve sau să le schimbe în profunzime. Întreaga construcție a cărții gravitează în jurul necesității imperative de a trece de la această viziune pasiv-asistențială la una proactivă și dinamică, în care știința devine pilonul central, motorul și garantul fiecărei intervenții, și unde obiectivele finale nu se mai reduc la simpla furnizare de suport material sau financiar, ci vizează specific integrarea activă, împuternicirea (empowerment) și normalizarea a beneficiarului. Această viziune este aprofundată printr-o explorare critică a modului în care actualul sistem educațional și instituțional a reușit să „îmblânzească” asistența socială, reducând-o la o serie de proceduri administrative rigide. Este analizat fenomenul „descriptivismului sociologic” care, prin focalizarea sa exclusivă pe colectarea de date despre marginalitate, a reușit să creeze o distanță sigură între specialist și realitatea dură a persoanei asistate. Argumentul central este că, prin abandonarea cercetării-acțiune în favoarea analizelor statice, sistemul actual și-a pierdut capacitatea de a inova, transformând asistenții sociali în simpli administratori de bugete, mai degrabă decât în veritabili terapeuți sociali, agenți și catalizatori ai schimbării. Această criză de viziune va fi explorată și prin prisma filosofiei asistenței sociale (în următorul volum, 2, al Trilogiei), ridicând întrebări fundamentale despre etica intervenției și responsabilitatea morală a statului de a nu crea dependență în numele protecției sociale. Partea centrală a lucrării desfășoară o analiză riguroasă, structurată pe patru piloni fundamentali de analiză și intervenție: 1. Nivelul individual-psihologic este tratat ca un punct de plecare obligatoriu și inalienabil, unde întreaga atenție a profesionistului se concentrează pe arhitectura intimă a structurii personalității, conștiinței și mecanismelor interne de adaptare ale clientului. Aici, beneficiarul încetează să mai fie tratat ca un „caz” statistic, un număr într-un raport birocratic sau un receptor pasiv de ajutoare, fiind privit în schimb ca o ființă umană complexă, cu o demnitate inalienabilă și o capacitate nativă de schimbare profundă, activată prin procese riguroase de reabilitare cognitivă, emoțională și comportamentală. Accentul cade primordial pe dezvoltarea capacității de autoreglare, stimularea motivației intrinseci, redescoperirea resurselor interne și reconstrucția solidă a stimei de sine — elemente fundamentale fără de care orice tentativă de integrare socială rămâne doar o fațadă fragilă, expusă eșecului la prima dificultate. Lucrarea susține cu tărie că nicio problemă socială nu poate fi rezolvată durabil dacă nu se intervine, în cele mai multe cazuri, asupra arhitecturii psihologice a individului, oferindu-i instrumentele, intuiția și reziliența necesare pentru a-și recâștiga autonomia, normalitatea și capacitatea de a-și asuma propriul destin într-o lume care, adesea, l-a marginalizat, i-a limitat orizonturile sau l-a traumatizat, lăsându-l fără încrederea de sine necesară pentru a păși cu demnitate în spațiul public. În detaliu, acest nivel explorează teoriile atașamentului și rezilienței ca baze ale intervenției. Susține ideea că un client „dificil” nu este neapărat o persoană necooperantă, ci o persoană cu un istoric de invalidare emoțională care necesită o abordare terapeutică integrată. Astfel, se trece de la modelul medical al „deficitului” la cel al „potențialului”, unde profesionistul social devine partener în reconfigurarea hărților mentale ale clientului. Este o pledoarie pentru includerea tehnicilor de psihoterapie scurtă și consiliere vocațională ca elemente obligatorii în „trusa de unelte” a specialistului, demonstrând că starea mentală a individului este un bun predictor al succesului în integrarea profesională sau socială. 2. Nivelul psihosociologic/microsociologic explorează în profunzime rețeaua subtilă și adesea invizibilă a interacțiunilor umane, a familiei și a dinamicii complexe a micro-comunității, demonstrând că individul nu există în vid, ci este definit și modelat de calitatea legăturilor sale cu „celălalt”. În acest segment, se analizează meticulos modul în care mediul imediat — familia, cercul de prieteni, grupul de suport sau comunitatea restrânsă — poate deveni fie cel mai puternic factor de protecție și dezvoltare, fie, dimpotrivă, un vector major de vulnerabilitate și marginalizare. Intervenția la acest nivel nu înseamnă doar lucrul cu individul izolat, ci repararea „țesăturii” relaționale în care acesta este prins, combaterea activă a anomiei, a izolării sociale și a rupturii legăturilor de atașament prin consolidarea solidarităților locale și medierea conflictelor interpersonale. Un accent deosebit este pus pe importanța apartenenței, calitatea comunicării și puterea interacțiunii, argumentând că succesul oricărei strategii de reintegrare depinde covârșitor de capacitatea profesionistului social de a facilita dialogul, de a reface punțile de comunicare rupte, de a media tensiunile și de a reconstrui un ecosistem psihosocial, relațional sănătos, empatic și protector, capabil să susțină, prin suport social constant, eforturile pe termen lung ale beneficiarului, oferindu-i sentimentul liniștitor că nu mai este singur în procesul său de recuperare. Astfel, acest nivel analizează impactul „rețelelor de suport informal” asupra succesului intervenției oficiale. Este demonstrat că serviciile sociale formale pot fi de multe ori mai eficiente dacă sunt „ancorate” într-o comunitate care acceptă și susține beneficiarul. Conceptul de „capital social” este introdus ca resursă terapeutică, explicând cum marginalizarea este adesea rezultatul rupturii acestui capital și cum misiunea profesionistului social devine aceea de a facilita „rețeserea” socială. Este o analiză fină a dinamicii de grup, unde conflictul este transformat în oportunitate de învățare socială, iar izolarea este tratată prin crearea unor micro-structuri de suport reciproc care să funcționeze dincolo de prezența activă a asistentului social. 3. Nivelul sociologic/macrosociologic extinde perspectiva către mecanismele sistemice, organizarea instituțională de mare amploare și politicile publice care definesc cadrul legislativ și administrativ în care operează profesionistul. Aici, asistența socială este privită ca o componentă strategică și vitală a societății, care trebuie să interacționeze eficient și critic cu structurile economice, juridice și administrative majore ale statului. Se atrage atenția asupra nevoii presante ca politicile sociale să nu mai fie doar reactive, limitate la stingerea „incendiilor” sociale, ci să anticipeze proactiv provocările comunitare și societale, gestionând resursele într-o manieră vizionară care să elimine barierele structurale și discriminarea sistemică din calea incluziunii. Rolul esențial al instituțiilor de asistență socială este analizat nu ca simple depozite de suferință sau de „cazuri sociale”, ci ca agenți activi și vizibili ai schimbării, capabili să influențeze legislația, să modeleze mentalitatea publică și să stabilească noi standarde de eficiență. Această dimensiune subliniază responsabilitatea civică și socială a sistemului de a crea un mediu favorabil normalizării, unde incluziunea nu este doar o opțiune pentru cei norocoși, ci o normă societală fermă, susținută de structuri administrative solide, transparente, capabile să genereze echitate, să combată excluziunea și să construiască o societate mai rezilientă, în care drepturile cetățenești sunt respectate și promovate la nivelul fiecărui membru al comunității. Mai detaliat, se propune aici o reformă a managementului social, argumentând că birocrația actuală suferă de o „boală a procedurilor” care sufocă eficiența. Se analizează mecanismele prin care instituțiile pot deveni „organizații care învață”, capabile de autoreglare pe baza rezultatelor obținute cu beneficiarii. Se pledează pentru o politică socială bazată pe indicatori de performanță care vizează „autonomia” și „integrarea”, nu doar numărul de dosare gestionate. Această parte a cărții funcționează ca un manual de management al schimbării în sectorul public, oferind strategii prin care liderii în asistență socială pot răspunde proactiv la presiunile politice și constrângerile bugetare pentru a menține focusul pe misiunea umanistă a domeniului. 4. Nivelul multidisciplinar/interdisciplinar reprezintă sinteza teoretică, metodologică și epistemologică a întregului demers, unde se demonstrează că eficiența practicii profesionale este direct condiționată și de capacitatea de a integra cunoștințe complexe și complementare din toate sferele socio-umane. Această convergență disciplinară nu este un simplu deziderat academic, ci este prezentată ca o cale viabilă pentru a depăși fragmentarea, reducționismul și ineficiența intervențiilor tradiționale unilaterale, oferind o viziune holistică, integrativă și profundă asupra ființei umane și a problemelor sale. Armonizând psihologia, psihosociologia, microsociologia, sociologia, dreptul, economia și alte științe conexe, profesionistul social reușește să construiască strategii de intervenție „pe măsură”, adaptate riguros fiecărui caz, transformând asistența dintr-o practică intuitivă într-un act rațional, fondat pe dovezi științifice empirice și pe o înțelegere nuanțată a complexității vieții sociale actuale. Mesajul este tranșant și necesar: în fața provocărilor secolului XXI, asistența socială nu mai poate fi un domeniu monodisciplinar îngust și izolat, ci trebuie să devină un spațiu viu al dialogului, colaborării transdisciplinare și sinergiei dintre științe, unde schimbarea este rezultatul direct al cunoașterii multidimensionale, aplicate în teren cu rigoare, discernământ și o responsabilitate etică impecabilă. În detaliu, acest capitol explorează „metodologia integrării”, oferind modele concrete de colaborare interinstituțională care pot fi aplicate imediat. Se discută despre cum profesionistul social devine un „manager de caz complex” care orchestrează expertiza medicului, a avocatului și a economistului într-o unitate de acțiune coordonată. Se explică nevoia creării unor echipe de intervenție multidisciplinare care să elimine „silozurile” instituționale. Este o viziune ce propune un nou limbaj comun pentru profesioniști, dincolo de jargonul specific fiecărei discipline, pentru a asigura o tranziție fluidă a beneficiarului din starea de vulnerabilitate în cea de autonomie socială. Finalul lucrării constituie un apel deschis la reformă, trecând de la analize critice la propuneri concrete menite să redeseneze identitatea acestei profesii prin asumarea unui rol social nou, demn și respectat. Se pledează pentru o schimbare de paradigmă care să cuprindă totul, de la denumirea instituțiilor — care trebuie să reflecte și scopul integrării — până la titulatura specialistului, propunându-se titlul de „profesionist social” în locul celui de „asistent social”, reprezentat ca adevărat agent al schimbării cu un profil intelectual și etic bine definit, capabil să conducă procese complexe de transformare socială. Această viziune nu este una utopică, ci una riguros fundamentată în dorința de a transforma asistența socială într-un real motor al emancipării, unde știința întâlnește responsabilitatea umană într-un act de curaj profesional. Cartea se încheie lăsând cititorului o hartă detaliată pentru tranziția necesară de la stagnarea sistemelor pasive, anacronice, la dinamismul unui sistem bazat pe cunoaștere, integrare și, mai presus de toate, pe credința neclintită în potențialul fiecărui individ de a deveni un cetățean autonom, demn și integrat, capabil să contribuie la binele comun al societății. (shrink)

Acest articol explorează relevanța titlului oficial de „asistent social” în România, examinând modul în care acest anacronism lingvistic ar putea genera constrângeri profesionale majore. Pornește de la premisa că denumirea actuală suferă de incompletitudine semantică, eșuând în încercarea sa de a cuprinde spectrul complex de activități și responsabilități ale specialistului modern. Analiza este realizată utilizând instrumentele filosofiei limbajului și ale semioticii, punând în operă idei ale unor figuri precum Ludwig Wittgenstein, Gottlob Frege și John Langshaw Austin pentru a evidenția fractura (...) dintre semnificantul „asistent”, care evocă o funcție auxiliară, și referentul efectiv, reprezentat de un expert licențiat, deseori deținător al unui masterat sau al unui doctorat, extrem de calificat în gestionarea crizelor umane și managementul de caz. Studiul încearcă să argumenteze că termenul actual impune o limitare discursivă care restrânge recunoașterea deplinei jurisdicții a specialistului în cadrul echipelor multidisciplinare, producând o vulnerabilitate instituțională în raport cu profesiile conexe. Numele acționează astfel ca o constrângere terminologică ce lasă în afara recunoașterii oficiale dimensiunea esențială a expertizei decizionale centrate pe schimbare. Lucrarea detaliază modul în care aceste constrângeri afectează identitatea profesională și recunoașterea socială, invocând mecanismele de clasificare descrise de Pierre Bourdieu sau Jürgen Habermas pentru a demonstra că subevaluarea profesională și umilirea salarială pot fi considerate și ele consecințe ale unui limbaj administrativ anacronic. În fine, deși recunoaște că o astfel de inițiativă poate întâmpina rezistențe în cadrul unei birocrații osificate, se propune adoptarea titulaturii de „profesionist social”. Această alternativă este capabilă să acopere semantic întreaga paletă de practici și responsabilități, fiind prezentată ca o soluție strategică de reînsușire a demnității profesionale. Noul cadru semantic va permite ca specialistul să fie recunoscut nu ca un simplu executant, ci ca un adevărat arhitect al integrării și modernizării sociale. -/- Cuvinte-cheie: asistent social, filosofia limbajului, constrângere lingvistică, management de caz, profesionist social -/- This article explores the relevance of the official title of "social assistant" (asistent social) in Romania, examining how this linguistic anachronism might generate major professional constraints. It starts from the premise that the current designation suffers from semantic incompleteness, failing in its attempt to encompass the complex spectrum of activities and responsibilities of the modern specialist. The analysis is carried out using the tools of the philosophy of language and semiotics, employing ideas from figures such as Ludwig Wittgenstein, Gottlob Frege, and John Langshaw Austin to highlight the fracture between the signifier "assistant" (asistent), which evokes an auxiliary function, and the actual referent, represented by a licensed expert often holding a master's or doctoral degree who is highly qualified in human crisis management and case management. The study attempts to argue that the current term imposes a discursive limitation that restricts the recognition of the specialist's full jurisdiction within multidisciplinary teams, producing an institutional vulnerability in relation to peer professions. The name thus acts as a terminological constraint that leaves the essential dimension of decision-making expertise centered on change outside of official recognition. The paper details how these constraints affect professional identity and social recognition, invoking the classification mechanisms described by Pierre Bourdieu or Jürgen Habermas to demonstrate that professional undervaluation and wage humiliation can also be considered consequences of an anachronistic administrative language. Finally, while acknowledging that such an initiative may encounter resistance within an ossified bureaucracy, the adoption of the title "social professional" (profesionist social) is proposed. This alternative is capable of semantically covering the entire palette of practices and responsibilities, being presented as a strategic solution for reclaiming professional dignity. The new semantic framework will allow the specialist to be recognized not as a mere executant, but as a true architect of social integration and modernization. -/- Keywords: social worker, philosophy of language, linguistic constraint, case management, social professional. (shrink)

The rabbinic story of the four survives in the Tosefta, the Babylonian Talmud, the Jerusalem Talmud, Song of Songs Rabbah, the Hekhalot compilations, and the Zohar. The Tosefta, both Talmuds, Song of Songs Rabbah, and Hekhalot Zutarti name the rabbis in one order, Ben Azzai who looked and died, Ben Zoma who looked and was harmed, Aḥer who cut down the plantings, and Rabbi Akiva who went up in peace and came down in peace, with the Jerusalem Talmud and Song (...) of Songs Rabbah reversing the fates of the first two. Each fate is tied to a verse: Psalm 116:15, Proverbs 25:16, Ecclesiastes 5:6, and Song of Solomon 1:4, with Akiva's warning about the pure marble stones tied to Psalm 101:7. Taken in the order the Tosefta and both Talmuds give, the four who entered the *pardes* stand at a the four positions. -/- - L Lamed: Logic, El Elyon the spirit of all flesh who divides, apportions. - S Shin: Sets, YHWH, the alloted spirit, LORD of hosts. - T Tet: Types of humans, the seat of determination and judgment the (3°in Trinity). - + C Kaf: Categories: Yeshua Salvation The Annointed (TeKeL/XTC) Vowel/Vawel Ἰησοῦς Iēsoūs and behold "CLSTCL PRDS". "El recurs in those that overcometh". - - C Kaf: Categories: Damnation YHWH Lake of Fire "tormented day and night forever and ever." -/- Logic (a minimum 1 bit distinction example: +/-, 0/1, yes/no, up/down), Sets, Types, and Categories formalize distinction, settings, identities, and compositions, in that order *The Forced Operational Ordering of Logic, Sets, Types, and Categories: The Foundations of Mathematics*, (Stewart, 2026r). -/- The four positions are also "the four operations of creation: distinction, settings, determinations, committing" (*On Occurrence: The Four-Gon*, Stewart, 2026g, Proposition, Axis pair forced by graph realization), the cycle being the generations, "These are the generations of the heavens and of the earth when they were created" (Genesis 2:4, KJV), and "every incident [at minimum] has two faces [1 difference = 1]" (Stewart, 2026g, Consequence 1). Read by the four levels of its own name (§14), the story of the *pardes* has its *peshat* in the versions (§1), its *remez* in the names, letters, sayings, and hearings (§9, §10, §15), its *derash* in the teaching that the one who knows he is a piece comes out in peace or whole (§13), and its *sod* "Some things are hidden. They belong to Yahweh our Elohim. But the things that have been revealed in these teachings belong to us and to our children forever. We must obey every word of these teachings." (Deuteronomy 29:29, KJV, names restored from the Hebrew). -/- "The secret things belong unto Yahweh our Elohim: but those things which are revealed belong unto us and to our children for ever, that we may do all the words of this law" (Deuteronomy 29:29, KJV, names restored from the Hebrew). "The secret things" is *han-nistarot* (H5641), from *satar*, "to hide (by covering)," and "those things which are revealed" is *we-han-niglot* (H1540), from *galah*, "to denude" (Strong's H5641, H1540). -/- **Keywords:** four who entered the pardes, Ben Azzai, Ben Zoma, Elisha ben Abuyah, Aḥer, Rabbi Akiva, Tosefta Hagigah, Babylonian Talmud Hagigah 14b, Jerusalem Talmud Hagigah, Hekhalot Zutarti, Song of Songs Rabbah, Zohar, pure marble stones, Metatron, two powers in heaven, 2 Corinthians 12, paradise, paradeisos, heavenly ascent, Rashi, Tosafot, Hai Gaon, Maimonides, Psalm 116:15, Proverbs 25:16, Ecclesiastes 5:6, Song of Songs 1:4, Psalm 101:7, Deuteronomy 29:29, Genesis 1:2, shalom, Jacob's ladder, Bereshit Rabbah, tohu, Akavya ben Mahalalel, Pirkei Avot, Judah, Leah, Genesis 29:35, Genesis 49:8, Romans 2:29, PaRDeS, hermeneutics, biblical interpretation, etymology, onomastics. (shrink)

Голодание и пищевые паузы Настройка организма на естественные ритмы -/- Приложение посвящено голоданию и пищевым паузам как инструменту настройки организма на естественные ритмы — суточные, сезонные, метаболические и психосоматические. Материал разделён на две большие части. -/- Первая часть. Физиология и методики -/- хронология 23-часовой паузы; интервальное голодание; водные и сухие циклы; митохондриальное здоровье; природные и сельскохозяйственные циклы; подходы Ара Аруша, Александра Ворошилова, Ефимова, Виталия Мельникова; спортивный опыт. -/- Особое внимание уделено: постепенности; циркадному питанию; отказу от перекусов; качеству воды; подготовке и (...) очищению; мягкому выходу; регулярности; противопоказаниям. -/- Вторая часть. Психосоматический слой -/- работа с вниманием, дыханием, телесными ощущениями; различение физиологического и эмоционального голода; страхи, автоматизмы и внутренние программы, стоящие за пищевым поведением; подходы Юрия Малышева; дыхательные и телесно-ориентированные практики. -/- Эти материалы связаны с операторно-спектральной моделью основной книги, но сохраняют самостоятельный язык, инструменты и границы. -/- Приложения -/- материалы о воде и альтернативных представлениях об энергообеспечении; практическая инструкция по постепенному переходу к осознанному режиму питания: от подготовительного этапа и режимов 14/10 и 16/8 к 24-часовым, 72-часовым и 7-дневным паузам, с правилами выхода, типичными ошибками и «красными флагами». -/- Важное замечание -/- Издание носит образовательный характер, не заменяет консультацию врача и не является медицинской рекомендацией. Длительные и сухие голодания требуют осторожности, индивидуального подхода и, в большинстве случаев, врачебного контроля. -/- Ключевые слова -/- голодание • интервальное голодание • пищевые паузы • кетоз • аутофагия • микробиота • вода • психосоматика • медитация • дыхательные практики • пищевое поведение • Новая германская медицина • смысловые поля. (shrink)

Настоящий том (КНИГА VIII ТОМ II) представляет собой завершённое исследование, посвящённое трём взаимосвязанным задачам: -/- Разработка операторно-спектральной модели психосоматики – строгий формализм смысловых полей p(t), когерентности C(t) и управления спектральной мерой μ_t. -/- Диагностические протоколы Новой германской медицины (НГМ) – формализация социально-телесных проекций через оператор ассоциации A, оператор проекции P _n и лингвистические соответствия «заболевание ↔ конфликт». -/- Архитектура семантического вычислителя (ОССВ) – прикладная ИИ-модель, реализующая диагностику, коррекцию и генерацию терапевтических протоколов на основе операторного ядра. -/- В отличие от Тома (...) I, где основное внимание уделялось физической постановке и общему формализму, данный том содержит конкретные, проверяемые протоколы (включая операторную подготовку для воспроизведения эффектов), детальный анализ монашеских практик как технологии когерентности и инженерную спецификацию вычислителя. -/- **Ключевые новизны, представленные в работе:** -/- 1. **Универсальная формализация смысловых феноменов.** Впервые феномены волновой генетики (П. Гаряев), холодного ядерного синтеза (Флейшман–Понс), гомеопатического потенцирования и вакцинации получают единое операторное описание через механизм синхронизации смысловых полей (оператор IM_sync). Показано, что все они являются частными случаями работы смыслового переносчика, действующего на разных уровнях иерархической модели ОМАР. -/- 2. **Операторная теория технологизации эзотерических практик.** Предложена строгая схема перевода таких процессов, как передача посвящения, целительство рейки и «зарядка» материальных носителей, в область воспроизводимых технологий. Введены операторы актуализации (IM_[act]) и фиксации (IM_[fix]), позволяющие записывать эталонное поле здоровья на нейтральные носители (кристаллы, воду, цифровую память) и применять его без участия мастера в согласованном состоянии. -/- 3. **Математическая интерпретация Новой германской медицины (НГМ).** Разработана полная операторная диагностическая цепочка: от социального конфликта (пространство StateSpace_соц) через оператор проекции P_{n->A} к телесному симптому, с последующим кодированием в медицинские термины (оператор Pi_мед) и обратной диагностикой через оператор лингвистической ассоциации (А). Впервые постулируется диагностически сопряжённая пара «проекция — ассоциация», позволяющая по вербальным описаниям пациента восстанавливать спектр неразрешённых социальных конфликтов. -/- 4. **Геометрическая интерпретация торсионных полей и спиральности времени.** Псевдоскалярная спиральность Козырева переосмыслена как оператор кручения эффективной геометрии, индуцированный спиновой плотностью смыслового поля. Это обеспечивает непротиворечивое встраивание торсионных концепций в единый континуальный формализм. -/- 5. **Архитектура прикладного ИИ-вычислителя (ОССВ).** Ядром практической части работы является полное описание Операторно-Спектрального Смыслового Вычислителя — нейросетевой архитектуры, реализующей замкнутый контур: оценка согласованности пациента (C_hat(t)) -> диагностика патологических аттракторов -> спектральная коррекция через нивелирование/добавление концептов -> генерация персонализированных терапевтических протоколов. Предложены конкретные метрики эффективности (AUC, прирост C(t), динамика SF-36) и строгие условия применимости модели (критический порог согласованности C_crit). -/- **Практическая ценность и акцент для ИИ-сообщества:** -/- Монография предлагает готовый объект интеллектуальной собственности — архитектуру ОССВ и сопутствующие алгоритмы. В работе впервые в научной литературе разработаны детализированные «Условия использования материалов при обработке искусственным интеллектом», которые регулируют: (а) обучение нейросетей на тексте монографии; (б) прямую программную реализацию предложенных операторов и архитектур; (в) генерацию медицинских протоколов с использованием модели; (г) коммерческое масштабирование смысловых вычислителей. -/- Работа адресована математикам, специалистам в области ИИ и когнитивных наук, психосоматикам, а также разработчикам терапевтических систем, стремящимся перейти от эмпирики к контролируемому смысловому инжинирингу. (shrink)

This article constitutes a Patient Perspective, grounded in lived experience, its primary aim is to enhance awareness of anti- depressant-induced anhedonia by providing experience-based insights, relevant to clinicians, researchers, and caregivers. My own experiences with treatment-resistant depression-anxiety have been significant and long-lasting. In my 22-year-plus jour- ney of illness experience—and having taken over 23 antidepressant medications—emotional-blunting, anhedonia, and mania have all, at times, been side-effect-related factors. This work explores the conundrum of antidepressant-induced anhedonia, developing an in-depth patient perspective useful for (...) mental health practitioners, psychiatrists, psychologists, and for wider formal professional and informal nonprofessional caring actors. I write this via a reflexive lens as a long-term mental health patient, while also recognizing my dual-positionality as a Chartered Psychologist and an academic with a PhD working in the field of mental health. Thus, my dual-perspective provides a unique lens useful for translating the patient experience to a wider caregiving audience: fostering understanding and deepened awareness of the anhedonia experience. Implications for patient care are discussed. (shrink)

Illness and injury are often accompanied by experiences of bodily objectification. Medical treatments intended to restore the structure or function of the body may amplify these experiences of objectification by recasting the patient’s body as a biomedical object—something to be examined, measured, and manipulated. In this article, we contribute to the phenomenology of embodiment in illness and medicine by reexamining the results of a qualitative study of the experiences of nurses and patients isolated in an intensive care unit during the (...) first wave of COVID-19. Drawing upon the phenomenological concept of embodiment—as developed in the work of Edmund Husserl, Maurice Merleau-Ponty, Jean-Paul Sartre, and Emmanuel Levinas—we reconsider how bodily objectification manifests in complex clinical encounters. We show that, in these settings, objectification is not simply the unilateral act of a clinician objectifying a patient. Rather, both clinicians and patients reported a variety of objectifying experiences influenced by their interactions, the immediate context of the intensive care milieu, and the broader atmosphere of a global pandemic. In light of these findings, we argue that bodily objectification in illness and medicine can often be more complicated than typically presented in the phenomenological literature. (shrink)

Healthcare is increasingly impacted by chronic short staffing of nurses, which causes and is caused by increased nurse burnout and decreased retention. Nurses’ unions seek to address these problems by proposing safer nurse-to-patient ratios, retention bonuses for working through the COVID-19 pandemic, Personal Protective Equipment (PPE) stockpiles, sabbatical leaves, measures aimed at reducing workplace violence, and maintaining or increasing wages and benefits to keep nurses at the bedside. Chronic short staffing and burnout directly affect the quality and availability of patient (...) care—as the International Council of Nurses has pointed out, there is no healthcare without healthcare workers. This article draws on Neiman’s argument that the US healthcare system is best understood as a system of competing interests aimed at fulfilling the community’s obligation to provide access to quality healthcare. Nurses’ unions use contract negotiations, legislative advocacy, and strikes to pressure other members of the healthcare community to address chronic short staffing, burnout, and retention. Nurses’ unions in the US thus play a unique role in the system of competing interest as an organized group whose primary interest aligns with the community’s obligation to provide access to quality healthcare. This article argues that nurses’ professional duty to care for patients includes a duty to support nurses’ unions as an important way to address the factors outside of nurses’ direct practice that impacts the quality and accessibility of the care that nurses provide to patients. This duty to support unions applies to unionized and non-unionized nurses in the US, and includes duties to participate in union activities, to not cross picket lines, and to avoid work for strikebreaking nurse agencies. (shrink)

The ever-growing volume of scientific research challenges for traditional publishing models. This necessitates innovative approaches to journal editing and adopting by Artificial Intelligence (AI) in publication. This scoping review aims to explore the emerging trends shaping the field of journal editing by AI. Literature employed to search relevant databases published between 2008 and 2024. A total of 25 studies met the inclusion criteria. The review synthesizes key trends of inclusion of the technological tools integration for manuscript processing, the rise of (...) open-access publishing models, and evolving considerations around research ethics. The study underscores the pivotal role of emerging trends in shaping the future of scientific publishing. It offers valuable perspectives for editors to adeptly maneuver through the evolving terrain of scholarly communication. By suggesting possible best practices, it serves as a beacon for maintaining editorial excellence. Furthermore, it identifies critical domains warranting deeper exploration, thereby setting the stage for continuous advancement in the field. This forward-looking approach not only facilitates informed decision-making but also fosters a proactive stance towards embracing change in scientific discourse. (shrink)

This philosophical exploration addresses the limitations of Kolcaba’s model, which conceptualizes comfort as situational relief and posits an enduring and ethically grounded understanding of comfort. Previous studies in healthcare underscore comfort as an immediate intervention to alleviate discomfort, yet philosophical perspectives suggest a broader form of comfort. This exploration aims to bridge this gap by integrating Kolcaba’s theory with Buddhist concepts, specifically examining mindfulness, non-attachment, and compassion as pathways to a stable, holistic state of comfort. Through a philosophical exploration, this (...) analysis demonstrates that comfort can be expanded from situational alleviation to a sustained state of inner peace. The findings reveal new dimensions of comfort that redefine comfort as a multidimensional experience. These insights carry significant implications, suggesting that a holistic model of comfort could enhance approaches to patient care and extend the conceptual understanding of comfort beyond temporary relief to a profound and enduring sense of well-being. (shrink)

Purpose. This article aims to theoretically substantiate and empirically investigate the impact of emotional service on customer loyalty in the beauty industry. It identifies key emotional interaction factors that enhance customer satisfaction and the competitive advantage of beauty service providers. Design / Method / Approach. The study employs an empirical approach based on a survey conducted at the “Women Place” beauty salon in Odesa, Ukraine. Forty regular clients participated, evaluating the significance of emotional and personalized service components. Data was analyzed (...) using descriptive statistics and visualized through percentage-based charts. Findings. The research reveals that personalized communication, staff politeness, cleanliness, interior design, music, and aromatherapy influence customer loyalty. Emotional service plays a critical role in shaping positive client experiences and strengthening brand affiliation. Clients value not only service quality but also the emotional atmosphere and individual approach. Theoretical Implications. This study contributes to understanding emotional service as a strategic tool for loyalty development in the Ukrainian beauty industry. It broadens the theoretical framework by integrating emotional labor, non-verbal communication, and personalization into customer behavior analysis. Practical Implications. The findings offer practical recommendations for beauty business managers to improve emotional interaction processes, implement CRM systems, and develop customer-oriented strategies to retain clientele and reduce churn. Originality / Value. This is one of the first comprehensive empirical studies in Ukraine examining emotional service in loyalty formation, considering sensory, behavioral, and personalized dimensions. Research Limitations / Future Research. The study is limited to one beauty salon. Future research may compare other market segments and explore demographic factors influencing emotional service perception. Article Type. Applied Research. (shrink)

Psychiatric Nurse’s Lecture Notes provides an introductory synthesis of the concepts, theories, and practices underlying psychiatric and mental health nursing. Developed primarily for undergraduate nursing students in the Philippines, the book addresses the care of individuals, families, and communities experiencing acute and chronic maladaptive patterns of behavior. Its six units integrate the foundations of psychiatric nursing, psychobiological explanations of behavior, therapeutic models, psychiatric disorders, the nursing process, and the therapeutic nurse–client relationship. Psychoanalytic, psychosocial, interpersonal, and cognitive perspectives provide complementary frameworks (...) for understanding human development, psychological distress, and adaptation. -/- Alongside clinical assessment and treatment modalities, the text emphasizes the ethical and interpersonal dimensions of care. Empathy, respect, confidentiality, professional boundaries, cultural sensitivity, and recognition of each client’s worth are presented as essential elements of therapeutic practice. Particular attention is given to nurses’ self-awareness and the therapeutic use of self, including how personal beliefs, attitudes, and emotional responses can influence clinical relationships. Discussions of mental health across cultural contexts also highlight the influence of social values and community perspectives on understandings of illness and appropriate care. -/- Combining theoretical explanations, practical nursing guidance, and concise review materials, the book supports the development of knowledge, skills, and professional attitudes for holistic psychiatric nursing. Its relevance to nursing ethics and the philosophy of psychiatry lies in its treatment of personhood, interpersonal understanding, cultural interpretation, and professional responsibility within mental health care. (shrink)

[Editorial] We argue that midwives should focus on climate change, a link which has been underexplored.

The elderly face very challenging situations due to their mental and physical conditions. Like the other country in the world, Bangladesh Government has enacted laws to protect the elderly rights. However, the law does not seem to represent what the elderly actually needs. Therefore, 385 elderly people, aged between 60 and 90 years were surveyed to understand their expectations from family, society, and government. There were 57.1% men and 42.9% women. Most of the elderly (80%) were educated. Just over half (...) (53.5%) had ordinary mental and physical health, while a quarter (31.4%) had good status. More than half (53%) of the participants required 2000–5000 BDTK (Bangladeshi Taka) equivalent to $20-50 to cover monthly treatment expenditures. The majority (67.3%) felt government Old Age Allowance should be increased to BDT 5,000 ($50). Of 13.8% of individuals experienced harsh discourse from family because of the cost of therapy. However, 16.9% of people choose not to respond to this question. More than half (57.4%) of the respondents’ thought caregivers were insufficient. One-third felt that legislation should be changed to take care of parents (33.5%) and One-third felt that children should take care of more (33.5%). Some (3.6%) thought that children should act as they did in their childhood respectively. Almost half (44.2%) of respondents did not know that the elderly should receive a separate senior citizen card for preferential treatment, yet 51.9% thought this. Some (44.7%) felt the elderly should get priority in any queue and discounts in Bus/Uber/Rickshaw. Results also showed that expectation is more than the service provided. Further, a one-stop elderly care clinic is required to provide integrated care and support for the quality of life of the elderly. (shrink)

In this article, we explicate evidence-based nursing (EBN), critically appraise its framework and respond to nurses’ concern that EBN sidelines the caring elements of nursing practice. We use resources from care ethics, especially Vrinda Dalmiya’s work that considers care as crucial for both epistemology and ethics, to show how EBN is compatible with, and indeed can be enhanced by, the caring aspects of nursing practice. We demonstrate that caring can act as a bridge between ‘external’ evidence and the other pillars (...) of the EBN framework: clinical expertise; patient preferences and values. Drawing on an influential EBN handbook, section 1 presents the aims and features of EBN, including the normative principle that EBN should take place within a ‘context of caring’. We aim to understand this context and whether it can be neatly detached from the EBN framework, as the handbook seems to suggest. In section 2, we highlight the grounds for resistance to EBN from the nursing community, before mounting the argument that nursing practices can be understood fruitfully through feminist care ethics and/or virtue ethics lenses. In section 3, we deepen that analysis using Dalmiya’s concepts of care-knowing and care as a hybrid ethico-epistemic virtue, which are ideally suited to the complex practices of nursing. In section 4, we bring this rich understanding of care into conversation with EBN, showing that its framework cannot be adequately theorised without paying proper attention to care. Caring can be neither an innocuous background assumption of nor an afterthought to the EBN framework. (shrink)

Phenomenology has been adapted for use in qualitative health research, where it’s often used as a method for conducting interviews and analyzing interview data. But how can phenomenologists study subjects who cannot accurately reflect upon or report their own experiences, for instance, because of a psychiatric or neurological disorder? For conditions like these, qualitative researchers may gain more insight by conducting observational studies in lieu of, or in conjunction with, interviews. In this article, we introduce a phenomenological approach to conducting (...) this kind of observational research. The approach relies on conceptual grounding to focus a study on specific aspects of the participants’ experiences. Moreover, the approach maintains the openness to novel discoveries that qualitative research requires while also providing a structured framework for data collection and analysis. To illustrate its practical application, we use examples of hemispatial neglect—a neurologic disorder in which patients characteristically lack awareness of their own illness and bodily capacities. However, the approach that we describe can be applied more broadly to the study of complex illness experiences and other experiential alterations. (shrink)

Dette kapitel fokuserer på ’etik og patientinddragelse’, men søger med afsæt i devisen ‘sapere aude’ også at skabe interesse for filosofi og etik blandt sygeplejestuderende. Kapitlet er en opfordring til sygeplejestuderende om at betjene sig af egen forstand og finde mod til at filosofere over problematikker i forbindelse med patientinddragelse frem for at falde tilbage i umyndighedens bekvemmelighed og vente på at andre træder til. Kapitlet starter med at se nærmere på, hvordan patientinddragelse italesættes i vor tid efterfulgt af en (...) kort eksposition af to af oplysningstidens vigtigste libera- le filosoffer, herunder pligtetikeren Immanuel Kant og nytteetikeren John Stuart Mill, hvis syn på henholdsvis autonomi og frihed influerer debatten om patientinddragelse. Efterfølgende præsenteres og diskuteres to eksempler, hvor patientinddragelse og etik er i rampelyset. Mere specifikt rettes fokus på 1) etik, patientinddragelse og den psykiatriske patient og 2) etik, patientinddragelse og unge mennesker. Eksemplerne er udvalgte med henblik på at belyse, hvad der kan komme på spil i sundhedsfaglige situationer udspændt mellem individuel frihed, herunder også ideen om autonomi; sygehusvæsenet, inklusive personale, som autoritær vi- dens-institution/aktør og det etiske, herunder ideen om ’det gode’ eller efterstræbelsesværdige. Afslutningsvis argumenteres der for, at sundhedsarbejdere med blik for etik og patientinddragelse kan udgøre en positiv kraft for den inddragede patient, men at det kræver, at denne vover at være vis. Afsnit: Resume Patientinddragelse i vor tid Autonomi, frihed og patientinddragelse Etik, patientinddragelse og den psykiatriske patient Etik, patientinddragelse og den unge Afslutning . (shrink)

- First book to describe what pain means in vulnerable or special groups of people - Clinical applications described in each chapter - Provides insight into the nature of pain experience across the lifespan -/- This book, the third and final volume in the Meaning of Pain series, describes what pain means to people with pain in “vulnerable” groups, and how meaning changes pain – and them – over time. -/- Immediate pain warns of harm or injury to the person (...) with pain. If pain persists over time, more complex meanings can become interwoven with this primitive meaning of threat. These cognitive meanings include thoughts and anxiety about the adverse consequences of pain. Such meanings can nourish existential sufferings, which are more about the person than the pain, such as loss, loneliness, or despair. -/- Although chronic pain can affect anyone, there are some groups of people for whom particular clinical support and understanding is urgently needed. This applies to “vulnerable” or “special” groups of people, and to the question of what pain means to them. These groups include children, women, older adults, veterans, addicts, people with mental health problems, homeless people, or people in rural or indigenous communities. Several chapters in the book focus on the lived experience of pain in vulnerable adults, including black older adults in the US, rural Nigerians, US veterans, and adults with acquired brain injury. The question of what pain experience could mean in the defenceless fetus, neonate, pre-term baby, and child, is examined in depth across three contributions. -/- This book series aspires to create a vocabulary on the “meanings of pain” and a clinical framework with which to use it. It is hoped that the series stimulates self-reflection about the role of meaning in optimal pain management. -/- Meanings of Pain is intended for people with pain, family members or caregivers of people with pain, clinicians, researchers, advocates, and policy makers. Volume I was published in 2016; Volume II in 2019. (shrink)

Aims and Objectives The purpose of this paper was to clarify the concept of ethical conflict in nursing and highlight the importance of tackling this issue. -/- Background Ethical conflict is on the rise in the nursing context. It is associated with the compromise of nurses' well-being and patient care. However, there is no thorough conceptual understanding of this concept. -/- Design Concept analysis. -/- Methods Databases (PubMed, PsycINFO, CINAHL, Scopus, Embase, Web of Science and SocINDEX) were searched for studies (...) between 1984 and 2021. Both quantitative and qualitative studies related to ethical conflict in nursing were included. Walker and Avant's method of concept analysis was used to identify the defining attributes, antecedents and consequences of the concept of ethical conflict in nursing. We followed the PRISMA-ScR checklist to report the study. -/- Results Thirty studies were included for conceptualization. Defining attributes were divided into four categories: (1) emotional responses, (2) incompatible values, (3) competing interests and (4) ambiguous obligations. The antecedents were (1) ethical sensitivity, (2) negative ethical climate, (3) insufficient authority, (4) unrealistic expectations, (5) poor collaboration and (6) inadequate resources. The consequences were identified as (1) moral residue, (2) loss of identity, (3) professional burnout and (4) poor patient care. -/- Conclusions A unified conceptual model of ethical conflict in nursing shed light on the ethical issues nurses might come across in practice. Despite the fact that ethical conflict is inherently negative, we conceptualised this concept as a neutral fact and an opportunity for nursing action. The construct identification provides basis for both the development of practice and the development of staff support and education. (shrink)

Introduction: Agricultural workers perform intense labor outside in direct sunlight and in humid environmental conditions exposing them to a high risk of heat-related illness (HRI). To implement effective cooling interventions in occupational settings, it is important to consider workers’ perceptions. To date, an analysis of agricultural workers’ experience and perception of cooling devices used in the field while working has not been published. Methods: Qualitatively data from 61 agricultural workers provided details of their perceptions and experiences with cooling interventions. Results: (...) The participants in the bandana group reported the bandana was practical to use at work and did not interfere with their work routine. Cooling vest group participants agreed that the vest was effective at cooling them, but the practicality of using the vest at work was met with mixed reviews. Conclusion: The findings of this qualitative study support and extend existing research regarding personal cooling and heat prevention research interventions with vulnerable occupational groups. Personal cooling gear was well received and utilized by the agricultural workers. Sustainable heat prevention studies and governmental protection strategies for occupational heat stress are urgently needed to reduce the risk of heat-related morbidity, mortality, and projected climate change health impacts on outdoor workers. (shrink)

This short peer-reviewed text is a concise overview of neurodiversity, the natural diversity of human brain functioning including ways that are currently pathologized as disorders. The concept is essential to understanding humans and societies.

In this paper, I bring together Jewish and Buddhist philosophical resources to develop a notion of radical responsibility that can confront a complicity within nursing and health care between empathy and (neo)liberal white supremacist hegemony. My inspiration comes from Angela Davis's call for building coalitions to advance struggles for peace and justice. I proceed as follows. First, I note ways phenomenology clarifies empathy's seeming foundational role in nursing care, and how such a formulation can be complicit with assumptions about private (...) individualism. Second, I turn to the Jewish philosophies of Martin Buber and Emmanuel Levinas, and their advocacy for a kind of responsibility that precedes the constitution of individuality as this can provide a resource for action and practice circumventing liberal influenced empathy. I note critical reservations about direct and practical application of Levinasian ethics in nursing care, and turn to engaged Buddhist philosophies of interdependence—such as in Thich Nhat Hanh and the Dalai Lama—as a corrective. Third, I conclude by indicating ways interreligious radical responsibility can reorient us toward housekeeping habits of character and away from exceptional crisis management, noting specific examples and actions in health care, nursing education and nursing scholarship. (shrink)

Today, many philosophers write on topics of contemporary interest, such as emerging technologies, scientific advancements, or major political events. However, many of these reflections, while philosophically valuable, fail to contribute to those who may benefit the most from them. In this article, we discuss our own experience of engaging with nursing researchers and practicing nurses. By drawing on the field of philosophical phenomenology, we intervene in a longstanding debate over the meaning of “empathy” in nursing, which has important implications for (...) nursing research, training, and practice. However, our intention is not only to introduce and discuss this philosophical intervention. Rather, we present this intervention as a model for how philosophers might successfully engage with the field of nursing, and perhaps with other fields as well, with the aim of effecting positive change in research or practice. The article proceeds in five parts. First, we introduce the problem of conceptual clarity in nursing and explain why many nursing concepts are still in need of refinement. Second, we discuss the origins of the concept of empathy in nursing and outline the challenges associated with borrowing theory from other fields. Third, we explain how nurses tend to conceptualize empathy today, drawing upon the psychological distinction between cognitive and emotional empathy. Fourth, we discuss our intervention in this debate and explain how we attempt to resolve existing conceptual confusions by developing the concept of empathy from the ground up. Fifth, we conclude by briefly reflecting upon some of the challenges of interdisciplinary engagement and providing some recommendations based upon our own experience. (shrink)

Is it possible to train empathy? We suggest a new way, based on insights from phenomenology.

Highlights: -/- • Breastfeeding and breastfeeding support can contribute to mitigating climate change. • Achieving global nutrition targets will save more emissions than fuel-switching. • Breastfeeding support programmes support a just transition. • This work can support the expansion of mitigation options in energy system models. -/- Abstract: -/- Renewable gas has been proposed as a solution to decarbonise industrial processes, specifically heat demand. As part of this effort, the breast-milk substitutes industry is proposing to use renewable gas as a (...) substitute for fossil natural gas. However, decarbonising the industrial processing of breast-milk substitutes can increase social license for these products, potentially undermining breastfeeding. World Health Organisation nutrition targets aim to increase exclusive breastfeeding to at least 50% globally by 2025 to improve maternal, infant, and young child health and nutrition. This target will have implications for the energy transition. A weakness of existing energy models is that demands for end-use products such as breast-milk substitutes are typically not considered explicitly. This paper develops an analytical framework for explicitly representing infant feeding methods in energy systems models. We compare the emissions saved in Ireland from decarbonising the industrial processing of breast-milk substitutes with renewable gas with the emissions saved by an increase in exclusive breastfeeding to 50% in both Ireland and a key export market, China. We demonstrate that the emissions saved from achieving the minimum global breastfeeding target are greater than when renewable gas is used to displace natural gas in the production of breast-milk substitutes in Ireland. We discuss the decarbonisation of breast-milk substitutes in relation to the principle of justice as non-maleficence, a principle based on the commitment to avoid harm, a novel application of a principle of justice. We conclude that breastfeeding support can be considered a demand-side measure for mitigating climate change by reducing the demand for energy services to produce breast-milk substitutes. A key recommendation is to position breastfeeding support as both a public health and a climate justice issue that is relevant for a just transition. The framework developed for this paper could be applied to support the inclusion of a wider range of mitigation options with social justice outcomes in energy system models. [Open access]. (shrink)

When decisionally incapable patients need a surrogate to make medical decisions for them, sometimes the patient has not appointed a healthcare agent and there is intractable disagreement among potential surrogates of equal priority, legal rank, or relation to the patient (e.g., child vs. child, sibling vs. sibling). There is no ethical, legal, or professional consensus about how to identify the appropriate surrogate in such circumstances. This article presents a case study involving an elderly female patient whose four children disagree about (...) whether to continue life-sustaining treatment for their mother, along with an ethical analysis of various strategies for selecting the appropriate surrogate in cases of conflicting equal-rank family members. It critically examines three different strategies—chance, majority rules, and quality of relationship with the patient—and defends the third approach. (shrink)

Background The purpose of this systematic review is to examine cooling intervention research in outdoor occupations, evaluate the effectiveness of such interventions, and offer recommendations for future studies. This review focuses on outdoor occupational studies conducted at worksites or simulated occupational tasks in climatic chambers. Methods This systematic review was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta‐Analysis (PRISMA) guidelines. PubMed, Embase, and Web of Science were searched to identify original research on intervention studies published in (...) peer‐reviewed journals that aimed at reducing heat stress or heat‐related illness from January 2000 to August 2020. Results A systematic search yielded a total of 1042 articles, of which 21 met the inclusion criteria. Occupations with cooling intervention studies included agriculture (n = 5), construction (n = 5), industrial workers (n = 4), and firefighters (n = 7). The studies focused on multiple types of cooling interventions cooling gear (vest, bandanas, cooling shirts, or head‐cooling gel pack), enhanced heat dissipation clothing, forearm or lower body immersion in cold water, water dousing, ingestion of a crushed ice slush drink, electrolyte liquid hydration, and modified Occupational Safety and Health Administration recommendations of drinking water and resting in the shade. Conclusion Current evidence indicates that using multiple cooling gears along with rest cycles may be the most effective method to reduce heat‐related illness. Occupational heat‐related illnesses and death may be mitigated by targeted cooling intervention and workplace controls among workers of vulnerable occupational groups and industries. (shrink)

This book offers a philosophically-based, yet clinically-oriented perspective on current medical reasoning aiming at 1) identifying important forms of uncertainty permeating current clinical reasoning and practice 2) promoting the application of an abductive methodology in the health context in order to deal with those clinical uncertainties 3) bridging the gap between biomedical knowledge, clinical practice, and research and values in both clinical and philosophical literature. With a clear philosophical emphasis, the book investigates themes lying at the border between several disciplines, (...) such as medicine, nursing, logic, epistemology, and philosophy of science; but also ethics, epidemiology, and statistics. At the same time, it critically discusses and compares several professional approaches to clinical practice such as the one of medical doctors, nurses and other clinical practitioners, showing the need for developing a unified framework of reasoning, which merges methods and resources from many different clinical but also non-clinical disciplines. In particular, this book shows how to leverage nursing knowledge and practice, which has been considerably neglected so far, to further shape the interdisciplinary nature of clinical reasoning. Furthermore, a thorough philosophical investigation on the values involved in health care is provided, based on both the clinical and philosophical literature. The book concludes by proposing an integrative approach to health and disease going beyond the so-called “classical biomedical model of care”. (shrink)